Lives were lost but because of the losses many more lives have subsequently been lived happily and disease free, at least free of diseases spread by contaminated food.

Twenty-five years ago, Riley Detwiler of Bellingham, WA, died, the last of the four children who passed away as a result of the 1993 Jack-in-the-Box E. coli O157:H7 outbreak, sometimes referred to by the Centers for Disease Control and Prevention as the Western states outbreak.

Riley had never eaten a hamburger. He was secondarily infected by a classmate in his preschool who had the infection but his parents did not know it yet.

There had been prior outbreaks from these bacteria, but none as extensive as this one which became infamous and made Bill Marler synonymous with foodborne illnesses.

But the past is behind us, and I want to take a few minutes on this unhappy anniversary to make note of the changes that came about in the world of food safety as a result of it. Lives were lost but because of the losses many more lives have subsequently been lived happily and disease free, at least free of diseases spread by contaminated food.

The industry and the regulators made changes, some of which, in no particular order, were:

Probably first and foremost, E. coli O157:H7 was declared an adulterant in ground beef, announced by Mike Taylor, then the acting undersecretary for food safety at the U.S. Department of Agriculture, at an annual meeting of the American Meat Institute, a move which took industry by total surprise. It also assured that the then acting undersecretary for food safety at USDA would never be Senate confirmed.

E. coli O157:H7 was upgraded to reportable disease status at all state health departments.

After losing a court battle to reverse Taylor’s decision, the meat industry declared that food safety and public health measures were not proprietary properties.

Hot steam vacuum treatment of carcasses was invented and refined by scientists at the Meat Animal Research Center in Clay Center, Neb., a very small town boasting more PhDs per capita than any other town in the U.S.

Pulse Field Gel Electrophoresis (PFGE) was developed by the Centers for Disease Control (CDC) and shortly became a part of every state health department laboratory performing testing of human specimens in suspected cases of foodborne illnesses. It is also used to fingerprint bacteria grown from meat and poultry samples. PFGE allows what used to appear to be isolated cases of foodborne illnesses to be developed into clusters, enabling investigators to more quickly isolate the cause of the outbreak and regulators to remove contaminated product from stores and hopefully kitchens.

Food & Drug Administration increased the recommended temperature for cooking ground beef from 140 degrees F to 155 degrees. The current USDA recommendation is to cook to 160 degrees using a digital thermometer.

In 1997, following the Hudson Foods recall, and at the request of Nebraska’s Gov. Ben Nelson, the NCBA created BIFSCo (Beef Industry Food Safety Council). BIFSCo coordinates a broad effort to solve pathogen issues, focusing on research prioritization and information dissemination.

Then in 2003, BIFSCo sponsored the first beef safety summit, an annual event since then. At the first summit attendees signed an industry food safety pledge and committed to openly share data and information.

The National Cattlemen’s Beef Assn. (NCBA) created a blue ribbon task force headed by old friend Bo Reagan, then with the National Live Stock & Meat Board, a predecessor organization to NCBA where he became vice president of research and knowledge management at NCBA, to fund research into ways to reduce E coli in cattle and slaughterhouses. Bo has since retired from NCBA and now lives just a few miles north of me.

The USDA’s Food Safety & Inspection System (FSIS) went from the nearly 100-year-old, sniff-and-poke inspection system to one designed to prevent contamination by invisible pathogens like E. coli O157:H7 called HACCP, Hazards Analysis and Critical Control Points, that put more of the burden on the individual facilities.

FSIS also initiated testing for E coli O157:H7 in ground beef, later moving the testing to combo bins.

Industry also ramped up its own testing of ground beef in plants and could remove and cook or discard contaminated runs. Reporting of industry positives and presumptive positives has never been mandated, and few know what the exact contamination rate of ground beef is. FSIS only tests product after industry has tested and removed known problematic ground beef.

In spite of criticism from the industry, the FSIS introduced consumer education programs about the potential dangers in ground beef and safe handling and proper cooking instructions. Despite this effort many restaurants’ wait staff continue to this day to ask “How do you want your burger cooked” and my wife and daughter answer “medium.” AARGH!

Irradiation of ground beef was made routine by Schwann’s and Omaha Steaks and offered as an option at Wegman’s.

Safe Tables Our Priority, affectionately known as STOP, was formed representing mostly families who had lost a child to an E. coli O157:H7 infection but fighting to “prevent Americans from becoming ill and dying from foodborne illness.” The national organization is now known as STOP Foodborne Illness. Nancy Donley, who lost her only child to an E. coli infection, was the president of STOP when I was with the FSIS at USDA.

FSIS began identifying retail outlets where contaminated meat and poultry were sold in 2008 to help consumers be more aware if they had eaten contaminated product or still had it in their refrigerator or freezer.

Recently, FSIS has begun attempting to trace back to the source when a further downstream processor has a ground beef sample test positive for E. coli O157:H7

Six other non-O157 STECs have been added to the list of adulterants in recent years by FSIS.

Some packers now use a phage spray on cattle in holding pens, others use hide washes before the knock box to reduce fecal contamination.

E. coli vaccines have been developed and gained FDA approval, but are in limited use because of the added cost.

I am certain I have left out a few critical changes, as most were made well before my attention turned from delivering babies to food safety. Please add your thoughts in the comment section.

Today marks the 25th anniversary of the day the last of four young children died during the landmark 1993 Jack in the Box E. coli outbreak.

Riley Edward Detwiler

I learned about the reality of this foodborne pathogen on Riley’s deathbed. When he was only a few months old, I justified being out to sea on a Navy submarine by telling myself that I was making the world a safer place for him, and I thought that I would spend the rest of my life making up lost time with him when he was older.

Riley would now be older than I was during that outbreak. I never got to see him grow older than he appears in the few photos and videos from so long ago. Over the years since his death, however, I have seen news of recalls and outbreaks and deaths on a far too regular basis. I have also seen much improvement in food safety.

We have gained new federal food safety regulations and policies at the USDA and, most recently at the FDA. We have witnessed advancements in science and data collection and even a whole new “culture of food safety.” We have training, certifications, university programs, conferences, magazines, books, and even movies that serve to inform and motivate new generations of food safety experts.

Many of the changes in food safety policies came about through the hard work of victims, families, advocacy groups and industry leaders. Statistics and charts alone achieve little without victim’s voices. Facts rarely motivate policymakers as much as seeing the faces and stories. I am very proud of their efforts. I am also proud to have stood with them and before them, trying to prevent other parents from looking at their family table with one chair forever empty due to preventable illnesses and deaths from foodborne pathogens.

One thing that hits me hard lately is how the faces and stories of victims from mass shootings are seemingly not enough to bring about change in terms of gun control. While no new policies will bring back the dead, they would bring hope and an increased safety for others. I am saddened by the thought that so many parents will live with the belief that their child’s death did not result in some element of change.

Perhaps the reasons matter not as to why parents worry about making the world a safer place for their children. Too many homes in this country include a chair forever empty at a family table due to reasons that could and should have been prevented.

Ron and Darlene Fields had been married for 26 years when they decided to take a “free” 12-day trip to Hawaii in fall 2016.

Ron was 62 then, and his construction business in Sarasota, FL, was really taking off. Darlene, who does paperwork for the company, had saved up credit card reward points so they could fly to Los Angeles, spend a night there and then fly to Maui for five nights before moving on to the Big Island.

The only things they expected to pay for were food and an excursion from one side of the Big Island to the other.

The Fieldses, physically fit and devoted for the past dozen years to eating organically, were a couple of days away from heading home when Ron got sick.

“My husband woke up in the middle of the night and couldn’t quite describe what was going on with his skin,” Darlene said during a telephone interview from their Florida home. “It was worse in L.A., and more when we got home. … We arrived home on a Saturday and by Thursday, he laid down in the bed — and he couldn’t get up for months.

“He called it burning skin pain. Then he started to have bladder problems and couldn’t urinate.”

Ron and Darlene Fields would end up taking a journey longer than any they’d imagined when they booked their flight to Hawaii.

Along the way, they’d go to emergency rooms, a hospital in Gainesville, FL, and an integrated health center. They’d see neurologists and urologists, general practitioners and meningitis specialists, medical marijuana consultants and acupuncturists and hypnotists.

The causeThe likely culprit behind it all: a tiny slug hiding in one of the many salads the couple ate during their trip.

The slug likely was home to a disgusting little parasite called rat lungworm that is carried in rat feces, which slugs and snails eat. The slugs and snails serve as intermediate hosts for the rat lungworms, which can’t mature or reproduce in humans but can cause a host of physical problems including eosinophilic meningitis and ocular Angiostrongylus if people ingest them.

The semi-slug, officially known as Parmarion martensi, is shown here on a nickel for scale. Photo courtesy of the Hawaii Department of Health

Rat lungworm infections typically come from eating raw or undercooked snails — or slugs — that can be in lettuce or other raw produce that hasn’t been washed thoroughly and/or cooked throughly. It has been endemic in Hawaii for at least the past 50 years, according to public health records.

Ron and Darlene Fields didn’t eat any snails, so they’re pretty sure Ron contracted the infection from a salad, which they ate every day of their vacation.

“You know, a Caesar salad or whatever they had in the restaurants,” Ron said in recent days.

Experts say early symptoms of rat lungworm infection can include headaches, neck stiffness, nausea and vomiting and that the illness might incubate for a single day or for as long as six weeks before symptoms appear. Infected people are not contagious. Recovery time varies in many cases from a couple of weeks to a couple of months.

Not so in the case of Ron Fields.

“We would go to the emergency room and to our family doctor. We tried acupuncture for the pain,” Darlene said. “During the couple of weeks after we arrived home, I could get him in the car and get him to the emergency room, but when he was home, he just lay in bed, too weak to walk, and any jostle in the car just caused excruciating pain.”

How they discovered the causeA couple of weeks into the whole thing, Darlene’s mom was flipping through the TV channels one day and caught the words “Big Island” and “rat lungworm” on the Animal Planet network. That sent Darlene on an internet search that led them to the answer.

Rat lungworm disease is reported in about 30 countries in Asia, Africa and Caribbean and Pacific Islands. In Hawaii 80 percent of land snails carry the parasite, which has caused two deaths in the islands since 2007. The state typically experiences one to nine rat lungworm cases a year.

In 2017, however, the Hawaii Department of Health recorded 18 laboratory-confirmed cases, said Anna Koethe of the department’s communications office.

The life cycle of the rat lungworm parasite, as depicted by the Hawaii Department of Health.

Ron Fields’ case is one of an unknown number not included in the public count because his illness, like other people who get sick after returning home, wasn’t reported to Hawaiian public health authorities.

In fact, despite dozens – if not hundreds – of medical tests, doctor visits and exams, Ron never got confirmation that he was infected by rat lungworm disease.

“We were confident of what it was, but they wanted to do another spinal tap to take more fluid, and my wife said no,” he said.

“It was confirmed that it was a parasitic form of meningitis, though.”

During all of their efforts to get a diagnosis and help, they encountered no one in Florida who had heard of the condition.

”They diagnosed all these silly things,” said Darlene. “We thought he was dying, and they said acid reflux, stress. It was just weird. Even after we found out what it was and told doctors, nobody had ever heard of it.

“We diagnosed it ourselves from the internet. I called the Big Island, the hospital, the CDC, I think, trying to get hold of a doctor who had treated it to see what we could do. … I finally called an emergency room in Honolulu and got a doctor who said it was untreatable but it would go away eventually.

“I said, ‘How long?’ and she said, ‘A long, long time.’ She said, ‘months,’ and I said, ‘He won’t make it months.’ ”

In the end, Ron Fields spent 10 months with a catheter because he couldn’t urinate. He spent nine days he doesn’t remember in the Gainesville hospital. He had IV treatments of vitamin C and he had problems with his bowels. He developed meningitis and had to have a spinal tap.

The time in Gainesville was a nightmare, Darlene said.

“All I did was tell my story every day, all day long,” she said. “Students, neurologists, doctors – and nobody knew anything. They were giving him a lot of antibiotics … trying to eliminate kinds of meninigitis.

“There was nothing to do to help him. He was losing weight. He was getting weaker and sicker instead of better. We went home after nine days and between October 2016 and January or February 2017, he determined he was never going to get better.”

Ron Fields is thankful that he is able to get out of bed, work some days, and spend time with family. Photo courtesy of Darlene Fields

Good days and bad daysRon is 64 now, and, most days, he goes to work but does less physical labor. He’s lost weight and agility.

“I don’t know if words can really describe (it),” he said. “It’s been challenging. As far as my balance and ability to be able to work every day without disability is about 90 percent.

“It took a while to get there. I still suffer from the neuropathy from the nerve damage that happened to me, and it’s just been a real struggle with that.”

Said Darlene: “Now, every morning he has to go through agony just to get his shirt on. It hurts so badly.”

Ron had to kick morphine, which doctors had him on for three or four months for the pain. He takes a nerve pain medication, but the Fields worry that it’s not good for him long-term. So, he uses medical marijuana, which has been legal in Florida since 2016.

The marijuana, which he uses in vaping form, makes life tolerable.

“We’re so thankful that medical marijuana is legal in Florida,” said Darlene, adding that it helps her husband sleep.

It doesn’t get him high.

“He doesn’t act drunk or high or anything but he’s not able to think as clearly,” she said.

“I thought it was wrong before,” she said of marijuana use. “But a neurologist recommended it and as a Christian he explained how he used to feel the same way, but as soon as we realized how many people it helped … it doesn’t bother us at all.

“Being able to sleep now is a big boost,” Darlene said.

The Fieldses have a type of alternative health insurance through Christian Healthcare Ministries for major medical expenses, but a lot of the treatment and pain relief they tried wasn’t covered.

It’s been challenging, Ron Fields said, but they’ve had help.

“I am a Christian, and if it wasn’t for the love of Jesus Christ and the relationship I have with him to give me the strength, I would never have made it.

“I have good days and I have bad days.”

Ron said he doesn’t rule out a return to Hawaii, but both he and his wife say they’d do things differently – no salads, and probably not even fruit or fruit juice.

“It’s changed our lives,” Darlene said. “We’ve lost hundreds of thousands of dollars. His business was really starting to thrive … and when we came back, he just couldn’t work.”

They considered seeking compensation through a lawsuit but since they don’t know where Ron picked up the parasite, there’s really no one to sue.

“We don’t want to sue,” she said. “That’s not the point. What bothered us is that nobody knew about it. We wouldn’t have gone to Hawaii in the first place, and we certainly wouldn’t have eaten like we did.

“We went to Hawaii because I always love to find ways to travel for free … I tell everybody it was the most expensive free trip ever.”

Public health actionThe Hawaii Department of Health launched a statewide public education campaign to raise awareness and inform people about best practices they can implement into their daily routines to prevent the spread of rat lungworm disease.

The first initiative, launched late in 2017, included a statewide broadcast media component through a partnership with the Hawaii Association of Broadcasters.

The campaign consists of three radio and three television commercials currently airing on 40 radio stations and seven television stations through the end of June 2018.

The department also has large-scale graphic advertisements displayed in malls and shopping centers across the state. It’s educational materials include rack cards, door hangers and posters that are being distributed during community events and health fairs.

]]>http://www.foodsafetynews.com/2018/01/parasitic-disease-from-hawaii-changes-couples-lives/feed/0Utah woman sues Costco for taking away her Broadway dreamhttp://www.foodsafetynews.com/2017/08/utah-woman-sues-costco-for-taking-away-her-broadway-dream/
http://www.foodsafetynews.com/2017/08/utah-woman-sues-costco-for-taking-away-her-broadway-dream/#respondTue, 08 Aug 2017 04:26:49 +0000http://www.foodsafetynews.com/?p=142711Continue Reading]]>Chicken salad purchased at Costco, which turned out to be contaminated with E. coli O157:H7, has ravaged the life of a 20-year-old Utah woman who’s had to give up her lifelong goal of acting on Broadway.

Attorneys for Chloe Rodgerson Monday sued the Seattle-based Costco Wholesale Corp. in U.S. District Court for the Central Division of Utah, seeking a jury trial to determine monetary damages for claims involving strict liability and negligence. She became ill after eating contaminated chicken salad purchased by her father in October 2015 at the Costco store in Lehi, UT. Her medical bills have already topped $2 million.

Diagram of a dreamBefore she was infected with E. coli O157:H7 from eating the chicken salad, Rodgerson’s life was dedicated to the performing arts, beginning at age 5. It included training and performing at the Hale Theater Youth Academy in Salt Lake City and continued with training with actor-director Brittni Smith in voice, acting, directing, musical theater and improvisation. She was cast for several school productions, including playing the lead role of Charlotte in “Charlotte’s Web.”

She went on to take voice lessons and additional training at the Utah Conservatory of the Performing Arts, again being cast in several plays and doing several commercials and advertisements by the time she entered high school.

The teenager then enrolled at the Pioneer High School for the Performing Arts in American Fork, UT, to focus on musical theater, dance and acting in addition to core classes. During summers she was involved in theater productions in New York, Los Angeles, Telluride, CO, and throughout Utah at the Tuacahn Theater in St. George, The Utah Shakespeare Festival in Cedar City, and on several Utah university campuses.

Rodgerson was featured in the Keith Merrill firm “Twelve Dogs of Christmas II.” In 2014, she went from being a film intern for the movie “Warpigs” to being hired as a paid production assistant. She was also the lead singer in three bands and was the principal talent in the T.C. Christensen film “Love Kennedy.”

The closest she’s been to her Broadway goal was an ensemble role in Jason Robert Brown Parade performed at Lincoln Center.

Her plans were to pursue an online degree while working as a Disney princess at Disney World in Orlando, an equity acting role that would have allowed her to acquire enough points for membership in Equity Actors Guide, which in turn would open audition opportunities.

But the E. coli infection meant she had to let the Disney job with salary and benefits go.

Never-ending nightmareAll 10 of the friends and family that dined on the chicken salad in October 2015, became sick with stomach cramping, diarrhea and gas pains. However Rodgerson’s reaction, according to the legal complaint, “was more traumatic: she was infected with E. coli O157:H7 bacteria, that infection would change her life forever.”

At age 18 she became one of the 5 percent to 10 percent of E. coli O157:H7 victims who develop hemolytic uremic syndrome or HUS. It is a condition caused by the toxin from the bacteria — known as a Shiga-like toxin — entering through the inflamed bowel wall, putting organs like the kidney, pancreas and brain at risk. Acute renal failure often develops.

Rodgerson began experiencing diarrhea on Oct. 27, 2015. Soon she was vomiting up blood and passing bloody in her stool. She was taken to an urgent care facility on Oct. 31 with continued abdominal pain, nausea, vomiting, diarrhea, chills and aching joints. She was referred to the emergency room at American Fork Hospital. Her culture was positive for E. coli O157:H7 and Pulse Field Gel Electrophoresis positively linked it to what was eventually identified as the Costco chicken salad outbreak strain.

Having developed HUS, Rodgerson was transferred on Nov. 6, 2015, to the Intermountain Medical Center, where she spent a month in shock traumatic intensive care. As she was being treated by a battery of specialists, she experienced renal failure and significant weight loss. Her large intestine was removed on Nov. 12, 2015. Numerous additional surgeries followed.

Rodgerson was able to go home on Nov. 26, 2015, but was back at the hospital two days later with seizures, which sent her back to intensive care. Her doctors found she had a staph infection from the prior surgeries. She was discharged again on Dec. 1, 2015, and started outpatient dialysis two days later. The sessions were necessary three times a week. They lasted several hours and resulted in excruciating headaches, nausea, anxiety and sensitively to light and sound.

On March 2, 2016, an MRI determined 19-year-old Rodgerson’s kidneys had lost all function and she would need a transplant. It also found she was diabetic due to the E. coli infection. After testing other family members without success, her fiancé proved to be the right match for a kidney transplant. Delayed once, the transplant surgery was performed on Feb. 24, 2017, but Rodgerson continued to suffer with a C. difficile infection, a bowel obstruction, and another seizure.

Fragile future
The federal court complaint says Rodgerson will require a lifetime of medical care and predicts “future medical expenses will be in the tens of millions of dollars.” Rodgerson has “undergone numerous painful surgeries, has suffered severe headaches, seizures, abdominal plain, chronic diarrhea and nausea. She has suffered depression and discouragement resulting from dramatic change in life plan,” according to the complaint. It says she’s been left diabetic with limited physical ability, and is “likely unable —practically, if not physically — from having children.”

Rodgerson won’t be able to work full time, her work skills have been “permanently diminished,” and she will experience a significant loss of income because of the E. coli infection caused by the contaminated chicken salad. But her lawyers say her principal losses are “her life and dreams of a couple of years ago…”

Rodgerson is represented by Lehi, UT, attorneys David M. Wahlquist and Adam D. Wahlquist and nationally known food safety attorneys William D. Marler and Bruce T. Clark. Costco has not yet responded to the complaint. The case is currently before Dustin B. Pead, Magistrate Judge for the District of Utah.

Editor’s note: William Marler is publisher of Food Safety News and a founding partner of Marler Clark LLP law firm in Seattle.

]]>http://www.foodsafetynews.com/2017/08/utah-woman-sues-costco-for-taking-away-her-broadway-dream/feed/0Food safety threat in plain sight; counter measures less clearhttp://www.foodsafetynews.com/2017/04/food-safety-threat-in-plain-sight-counter-measures-less-clear/
http://www.foodsafetynews.com/2017/04/food-safety-threat-in-plain-sight-counter-measures-less-clear/#respondThu, 27 Apr 2017 05:00:58 +0000http://www.foodsafetynews.com/?p=139619Continue Reading]]>Editor’s note: This is the first of a two-part series about food allergies and the efforts by public health agencies, schools, legislators and parents to make it easier and safer for allergic individuals to manage risks.

A chronic disease with no known cure. An emerging epidemic that affects up to 15 million people in the United States, including 1 in 13 kids, and more than 17 million people in Europe.

No, this isn’t about an unknown disease that has suddenly emerged out of nowhere, but rather one that has been here all long, although it’s becoming more prevalent. It’s food allergies, and for some people it’s a food safety issue that can be a matter of life and death.

Source: CDC

Food allergies among children increased about 50 percent between 1997 and 2011, according to a 2013 study released by the Centers for Disease Control and Prevention. And although the number of people with food allergies is increasing, there’s no clear answer as to why.

Simply put, a food allergy happens when the person’s immune system mistakenly targets a harmless food protein as a threat and attacks it.

Symptoms of allergic reactions to food can range from a rash and an itchy mouth to anaphylaxis, a severe and life-threatening reaction.

An anaphylactic reaction can include coughing, wheezing, tightness in your chest, fainting, swelling of the throat, shortness of breath, trouble breathing, trouble swallowing, and rapid heart beat. Generally the first line of defense for such reactions is an injection of epinephrine, which can be administered with an EpiPen. From there, and a visit to the emergency room.

According to the CDC, food allergies are the leading cause of anaphylaxis outside hospital settings. Anaphylaxis can also occur in people who are allergic to insect stings, medications and other non-food allergens.

Food Allergy Research & Education Inc. (FARE) , which is a non-profit organization, has this sobering information to share: Every three minutes, a food allergy reaction sends someone to an emergency room in the U.S. That adds up to more than 200,000 emergency visits per year.

Yet, the true prevalence of food allergies is unknown due to the misinterpretation of symptoms and the lack of simple diagnostic tests, according to a recent study done by The National Academies of Sciences, Engineering and Medicine.

With that in mind, the study outlines steps to address public health concerns about food allergy safety. No easy task, the study points out, because no research in the U.S. has been conducted with sufficient sample size and in various populations to determine how many people actually have food allergies.

To make matters worse, says the study, public health officials and health care providers frequently misinterpret a food allergy and its symptoms. Not only that, they often cannot differentiate a food allergy from other immune and gastrointestinal diseases, such as lactose intolerance and gluten sensitivity. Also, they frequently don’t know which management and prevention approaches are effective and the best ones to use.

‘We were out there on our own’Wisconsin mom Amber Stroud is living proof of how much more needs to be known about food allergies.

“We were out there on our own. We felt lost,” she said, referring to the time when she realized that her daughter Iris had food allergies.

Even though Iris had had allergic reactions to yogurt and cheese when she was still just a baby — her face swelled, turned red, and she developed a rash — her pediatrician told Stroud that Iris was fine because “you’re nursing her.”

But when Iris was a year old, an allergist ran some tests and discovered she was allergic to 29 things, among them wheat, rye, oats, barley, chicken, turkey, eggs, peas, soy, bananas, legumes, tree nuts and peanuts. Stroud was advised that she might have to homeschool her daughter.

“My whole world crashed. Who is there to help us,” she remembers thinking. “I needed someone to go to the store with us and show us how to shop for foods Iris could eat. I’d walk through the stores crying. Our whole world had changed.”

At one point, a dietician she was working with suggested they feed Iris some hummus, which is mashed-up garbanzo beans with tahini, aka sesame oil, mixed in.

After eating just one-eighth of a teaspoon, Iris had a potentially fatal anaphylactic reaction to the sesame, a product that doesn’t have to be labeled as an ingredient because it isn’t one of the Top 8 allergens that federal law requires to be declared on food labels.

Yet she also knows that things will get more challenging once Iris starts going to school,

With that in mind, Stroud has already been visiting the neighborhood school to talk about food allergies with teachers and staff.

“I’m trying to educate them now, before Iris goes to school,” she said. “Her teacher wants to be involved. After all, Iris won’t be the only child in the school with food allergies.”

As for the essential piece of education that’s still missing, Stroud sums it up like this: “Allergies can be deadly. Until you’ve lived it, you just don’t know.”

‘Our world changed forever’Irina Lerman remembers how she and her husband “high fived it” after they gave their 10-month-old son, Joshua, some peanut butter, and he had no reaction.

“We cleared all of the allergies, or so we thought,” she said.

Their son loved everything they gave him. Things were looking good. But then one day they gave him some hummus and “our world changed forever,” said Lerman. He started getting red and then broke out in hives and his left eye swelled.

She remembers yelling “Oh my God, he’s having an allergic reaction to something. What do we do?”

“Benadryl,” yelled her panic-stricken husband. “Give him some Benadryl.”

After giving him the antihistamine, they rushed to the emergency room. But by the time they got there, his hives had subsided and he seemed OK. So they drove to the pediatrician’s office instead.

Subsequent testing revealed that he had a severe allergy to sesame.

“At first we didn’t think much of it,” she said. “We assumed that sesame is easy to avoid. No hummus, no sesame bagels, no big deal.

“Again we were wrong.”

Doing some research, she discovered that sesame has 40 different names. And even more daunting, because sesame is not in the Top 8 allergens that must be included on labels, it can hide in natural flavors and spices. And cross-contamination can be a problem because equipment-cleaning rules don’t apply because it’s not one of the Top 8 allergens.

“My journey has been calling every company before giving my son anything,” she said.

But that has its own drawbacks as well since some companies won’t provide her with an answer when she asks if their products contain sesame. Often they’ll tell her that the information is proprietary.

However, some companies such as Kraft, General Mills and Pepperidge Farms are choosing to include sesame on their labels if it’s used in their products. When she thanked Pepperidge Farms for doing that, they told her that the company voluntarily calls out sesame “because we realize sesame is a top allergen.”

Lerman also shared her frustrations when going to restaurants. You can’t get a reliable answer from the wait staff or the chef as to whether sesame is in any of the foods. Most often they just don’t know.

An estimated 500,000 people in the United States are allergic to sesame, and that number is growing, most likely because more people are eating “exotic” foods than in the past. While Canada, Australia, Israel and most of Europe require sesame be declared on labels, the United States has no such requirement.

“We need sesame to be included as the top ninth allergen,” Lerman wrote in comments to the Food and Drug Administration about a proposed bill, ‘Food Labeling Modernization Act of 2015,’ which has of yet gone nowhere.

In those same comments, Lerman also pointed out that the recent study of food allergies by the National Academies of Science Engineering Medicine stated: “… evidence of allergy prevalence and reaction severity to sesame seeds may warrant their inclusion on the priority allergen list in the United States.”

Like Stroud, Lerman points to how serious all of this is. “There are allergies, and then there are life-threatening food allergies,” she said. “People need to be educated about this.”

Avoidance can be difficultAvoiding food allergens is not as easy as it might seem. People can avoid foods that contain ingredients there’re allergic to but cooking from scratch in their own kitchens, but it becomes complicated when dining away from home. Birthday parties, sleepovers, potlucks, restaurants, school cafeterias, and snacks grabbed as you run from one place to another all present the potential for an allergic reaction.

Virginia Stallings, director of the Nutrition Center at the Children’s Hospital of Philadelphia and professor of Pediatrics at the Perelman School of Medicine, University of Pennsylvania, says education is the key.

“… because people with food allergies are in different settings throughout their daily lives, concerted efforts by early care and education systems, schools and universities, food establishments, and the travel industry — in addition to the health care system — are necessary to bring about a safe environment for those with food allergies.”

Because of that reality, she said, many policies, practices, and behaviors could be changed in the short term to substantially improve food safety, which, in turn, would enhance the health and quality of life for individuals with this chronic disease and save lives.

One of those changes, says the study, would be to improve education and training for health care providers, patients and their caregivers, the food industry, and the general public. Along with this, the study recommends that public health authorities, such as the National Institutes of Health, the World Health Organization, and professional societies regularly update their guidelines on diagnosis, prevention and management of food allergies based on strong scientific evidence, as emerging data become available.

It also recommends that medical schools and residency and fellowship programs include training in the management of food allergies and anaphylaxis, which should go along with training on approaches to counseling patients and their caregivers.

And, of course, organizations that provide emergency training to first responders and the public should include food allergy and anaphylaxis emergency management in their training.

Preparation, preparation, preparationThat’s New York attorney Jill Mindlin’s mantra as she lives life with a daughter who has food allergies, although she has outgrown some of them now that she’s almost 16. Nevertheless, she’s still allergic to dairy, eggs, tree nuts and several other foods.

“There’s a loss of spontaneity,” Mindlin said, referring to events that pose problems with food allergies. Events like vacations, for example.

“If we’re going on a trip, we need to know where we’ll be eating,” she said. “We need to include that in our plans.”

Preparation is especially important now that her daughter, Maya, is close to going off to college. Mindlin knows she can’t go with her, of course, and so has been relinquishing control bit by bit and handing it over to her daughter.

“It’s been a difficult shift for me,” she said. “I don’t carry an EpiPen in my purse anymore. Now that’s her responsibility.”

Mindlin is the co-leader with a parent who’s a nurse of a support group that helps parents through the challenges of dealing with food allergies. The 100 to 150 members share information through emails. Mindlin was also a panel member who participated in the study.

Mindlin said that the parents in the support group learn the symptoms to look out for and how to prevent, recognize and respond to them. Besides the rashes and swelling and other well-known symptoms, there’s another symptom that many people don’t know about: the fear of impending doom. Not everyone with an allergic reaction experiences this symptom, but it’s important for people to know about. It happened to Mindlin once, and she actually collapsed in the hospital and lost consciousness.

“The learning curve is tremendous,” she said. “All of this is serious, which is why so much more research is needed.”

Recommendations from the study committeeUse proper diagnostic methods and provide evidence-based health care. This is important, the committee reported, because there are a lot of “non-standardized and unproven procedures” such as electro-dermal testing and applied kinesiology.

Even so doctors and other health care providers may recommend tests that are not scientifically proven to be effective in diagnosing food allergies. Parents may read about them on the Internet as they search for solutions.

The “Guidelines for the Diagnosis and Management of Food Allergy in the United States,” published by the National Institute of Allergy and Infectious Diseases, specifically lists tests that are unproven and non-standardized and are not recommended for the diagnosis of food allergy, many of which are included in the list below. They also warn that the tests can be risky. The guidelines recommend against:

“No simple accurate diagnostic tests exist for food allergy,” according to the study. “The patient’s medical history and other test results, such as from a skin-prick test, can suggest the likelihood of a food allergy, but it’s not enough to confirm a diagnosis.

Food industry leaders need to work to integrate food allergy training into existing food safety and customer service training for employees at all levels. This means including processing sites, retail food and grocery stores, restaurants and other foodservice venues.

The study’s authors also contend the current precautionary labeling system for allergenic foods is not effective in informing consumers about the risks from food allergens.

Looking aheadThe report recommends that within the next year, federal agencies such as the FDA, CDC, and the Federal Aviation Administration convene a special task force that includes participants from the medical community, food companies, and advocacy stakeholder groups to establish and implement policy guidelines.

The report also says that guidelines should ensure that emergency epinephrine capabilities such as EpiPens are in place for children and adults in public venues, including schools, early care and education facilities, and airplanes. Training in food allergy and anaphylaxis first aid should be provided to appropriate school and university health staff, early care and education providers and on-board flight crews.

The study was supported by:

Food and Drug Administration

Food and Nutrition Service of the U.S. Department of Agriculture

National Institute of Allergy and Infectious Diseases.

The Asthma and Allergy Foundation of America,

Egg Nutrition Center,

Food Allergy Research & Education,

International Life Sciences Institute North America,

International Tree Nut Council Nutrition Research & Education Foundation,

National Dairy Council,

National Peanut Board,

The Seafood Industry Research Fund.

The National Academies of Sciences, Engineering, and Medicine are private, nonprofit institutions that provide independent, objective analysis and advice to the nation to solve complex problems and inform public policy decisions related to science, technology, and medicine. The Academies operate under an 1863 congressional charter to the National Academy of Sciences, signed by President Abraham Lincoln. For more information, visit http://national-academies.org.

]]>http://www.foodsafetynews.com/2017/04/food-safety-threat-in-plain-sight-counter-measures-less-clear/feed/0His chair at the table is still emptyhttp://www.foodsafetynews.com/2017/02/his-chair-at-the-table-is-still-empty/
http://www.foodsafetynews.com/2017/02/his-chair-at-the-table-is-still-empty/#respondMon, 20 Feb 2017 19:21:02 +0000http://www.foodsafetynews.com/?p=137636Continue Reading]]>Exactly 24 years ago today my 16-month-old son Riley died from E.coli/HUS during the 1993 “Jack in the Box” outbreak. He was the last of the four young children who paid the ultimate price for failures in food safety protocols at that time.

The landmark outbreak is often referred to as the 9/11 of the food industry. In the many years since, we have gained new federal policies, advancements in science and in reporting data collection, and even a whole new “culture of food safety.”

I was 24 at the time and have now literally lived half of my life in the shadow of that event. Rarely a day goes by without reading of an illness, an outbreak, a death, or some other news item that reminds me of the faults in my early assumptions of the government or the industry solving the problems with food safety.

According to estimates from the Centers for Disease Control and Prevention, the years since my son died have witnessed over 1.1 billion Americans becoming ill, almost 3.1 million Americans hospitalized, and 72,000 American deaths due to foodborne pathogens. Most of these illnesses and deaths could have been prevented.

Some outbreaks and deaths were unintentional and could have been prevented with stronger policies and better training. Other incidents, unfortunately, have causes linked to greed and intent. A few notable trials — Peanut Corporation of America, the DeCosters of Quality Egg, etc. — show that some are able to consider the worst impacts on the lives and health of consumers as a cost of doing business. This should never be a cost that consumers, especially the young and vulnerable, should be expected to bear.

Today, I am a food policy professor, columnist, and food industry consultant. I gain much satisfaction in knowing that for every company that has failed to prevent such impacts on public health, hundreds of other companies place a high priority on food safety. They invest in ensuring that their products are going to be safe and wholesome.

While many, if not most food companies understand their role in preventing another illness or another death, far too many victims and families know the true burden of disease.

Too many homes in this country include a chair forever empty at a family table due to food safety failures.

At age 3, Jubilee Combs had to spend three weeks in the hospital and undergo dialysis treatments after contracting an E. coli infection fro drinking unpasteurized raw milk.

“I don’t know where to stick her; she doesn’t have any veins left.”

That’s a medical specialist talking as she examined 3-year-old Jubilee Combs, a patient at a Kentucky hospital undergoing dialysis for a severe kidney disease acquired from drinking unpasteurized raw milk.

That was two years ago while the little girl was being treated for hemolytic uremic syndrome, commonly referred to as HUS. In Jubilee’s case, the HUS was the result of an E. coli infection from contaminated raw milk.

In HUS, damaged red blood cells clog the filtering system in the kidneys, which can lead to life-threatening kidney failure. In children, especially, it is often caused by infection from certain strains of E. coli.

Jubilee’s mother Sarah had not yet connected the dots between her daughter’s dire medical condition and raw milk.

“I knew there were naysayers and that there are some risks associated with raw milk,” she said.“But I had no idea about HUS.”

Sarah and her husband Brandon had decided to switch their family to raw milk because their oldest son had had some health issues. When they did, his health seemed to improve.

“The kids loved it,” said Sarah, talking about her other two children. “It seemed to be better for their immune systems. We drank it for five years. The kids thrived on it.”

The family also had complete faith in the dairy’s sanitary practices. In switching over to raw milk, they had been advised “to know their farmer.” They believed they had done the right research to make sure the milk they were buying was safe to drink.

But then one day, Jubilee got sick — very sick. She was vomiting and suffering from a severe case of diarrhea. Instead of improving over the next several days, she got sicker and sicker.

Her worried mother took her to the emergency room, taking along a pull-on diaper that had blood in it.

“I knew something was very wrong,” Sarah said, “but the doctor just told me to give her plenty of fluids and sent us home. He didn’t administer any kidney-functioning tests.”

The next morning, the toddler was sick enough that Sarah took her to a pediatrician, who ran some tests. Sarah said that the tests were likely done because one of the pediatricians in the office had two daughters who had contracted E. coli from a petting zoo.

“So the doctors were more alert to it,” said Sarah.

The next morning, the results of the tests came back. “It’s E.coli,” she was told. “Jubilee’s kidneys are in danger.”

In almost no time at all, the toddler was in an ambulance headed to Kosair Children’s Hospital in Louisville.

And then, just like that, Sarah was told “We have an opening to do surgery this morning.” Right away, she knew things were serious.

From bad to worseMeanwhile, her son Titus, who had just turned 6, was also sick, but seemed to be handling it better. But then he got sicker and joined his sister in the hospital. He, too, developed HUS, although he didn’t need to undergo dialysis. But he did develop pancreatitis from the E. coli infection he had contracted from the contaminated raw milk, and then a staph infection.

Sarah quickly learned how serious HUS is and how painful dialysis and the treatment for pancreatitis can be.

“Watching them in pain was the absolute hardest thing I’ve ever done as a parent,” she said. “The amount of needles for blood draws, medications, transfusions is scary and the fear of each one only grew, making it harder not easier.”

At one point, the dialysis specialist actually teared up and told her he wasn’t sure how she was doing it — going back and forth from daughter to son and watching them go through the treatments and tests.

She was conflicted about the best way to handle it. She felt that if she walked out of the room, they would feel abandoned, but if she stayed, perhaps her anxiety would only make it harder for them.

“I tried both ways,” she said. “Hearing their cries outside of the room was torture for me.

“It’s hard to comprehend the number of needles involved. Four blood draws twice a day.”

Because her son had developed pancreatitis, he wasn’t allowed to eat or drink for three days.

“Mommy, do you want me to die or something,” he asked. “Please give me some ice. Mommy, do you not love me? Why can’t I eat?”

Titus and Jubilee Combs were delighted to be reunited in the hospital after three weeks of separation.

The brother and sister were put in rooms next to each other but couldn’t see or visit each other, which Sarah said was especially hard on them since they’re so close. Making things even harder for Sarah was that the children were in the hospital’s cancer ward, so she knew that many of the children there were fighting for their lives.

It was three weeks before the children were well enough to go home.

“I was in the hospital with them the entire time,” said Sarah. “I felt like a bat. It was still summer when they went in, and the stores were selling school supplies. When I came out, there were Christmas decorations in the stores.”

And while the children are doing well now and “playing with the best of them,” memories persist.

“Every little thing — a fever or when one of the kids gets sick — brings back so much fear,” she said. “I think it’s because of what happened to them.”

And it’s not over yet. A week ago, she took Jubilee and Titus in to have their blood tested. The hospital wants them to come back in December for full urinary testing and ultrasounds to check for scarring in the kidneys and pancreas in their son. Jubilee must return for testing every six months to make sure her kidneys are functioning. Her kidneys will remain more sensitive to illness, making any sickness more dangerous.

As for possible future complications, which isn’t uncommon with HUS, Sarah said it will be a matter of “monitor and see.”

Connecting the dotsSarah and Brandon didn’t know what had made their children sick, but when two other children with HUS were admitted to the same hospital, things started clicking into place. Both of the other children were also part of the same raw milk buying club their family belonged to and both had drunk raw milk from the same dairy, MDM in Hodgenville, KY.

“I didn’t want to believe it for a long time,” said Sarah. “I kept looking for other sources. Maybe it was from spinach, or maybe from the ice the milk had been packed in. I wanted it to be something else. I didn’t want it to be because of raw milk I had fed my family.”

Another mom, Amy Nordyke, whose 18-month-son Seamus was one of the other children in the hospital being treated for HUS, shared some similar feelings in a piece she submitted to Food Safety News in 2014 shortly after the E. coli outbreak. Seamus was fortunate and had a good recovery.

The Nordyke family had been buying raw milk from the dairy for eight years.

“I didn’t want to admit that something I’d actively chosen for my family all this time could have taken my child’s life,” she said. “It was painful, but I began to see the connection and had to humble myself and start to face the truth.”

And while she had absolute faith in the dairy’s sanitary practices, she said she realized that she was relying on everything happening perfectly twice a day, 365 days a year, including things outside the farmer’s control.

She describes HUS as an “evil sickness — one that can attack so many different areas of the body and lead to horrific things like strokes and brain damage.”

Consider the sourceLike Nordyke, Sarah had wanted to feed her family healthy, unprocessed foods. And like Nordyke, she had been beguiled by how some sources described raw milk. Information from the Weston A. Price Foundation describes it as “nature’s perfect food and extremely important for the developing brains and nervous systems of infants and children.”

The Centers of Disease Control and Prevention counters claims such as that with this warning: “Raw milk can carry harmful germs that can make you very sick or kill you. If you’re thinking about drinking raw milk because you believe it has health benefits, consider other options.”

Both moms now say they wished they hadn’t relied so much on sources that promoted raw milk as a healthy option — they wish they had scrutinized the information more carefully.

And they admit that the guilt that goes along with what happened to their children, based on choices they made, is something that haunts them.

“That’s been the hardest part for me,” said Sarah. “I’m just now accepting it. On one hand, I feel guilty because I made the decision to feed my family raw milk, yet as parents, you try to make the best decision for your family that you know how with the information that you have, and sometimes you get it wrong. I go back and forth between feeling so guilty and depressed over it and realizing I can’t change the past, I can only move forward. I cannot be a slave to fear of future parenting decisions because of it.”

She can’t help but express exasperation when she talks about how some people react when she tells them what happened to her children.

“My good friends who rode this out with me didn’t go back to raw milk,” she said. “But I have some acquaintances who still drink it. They stress that uncontaminated raw milk is good for you. But I don’t think in this day and age, anyone can be that sure about raw milk.”

When she says this, she’s referring to the fact that modern E. coli has evolved into an extremely virulent pathogen — in contrast to its weaker form in earlier days.

“My grandfather grew up drinking raw milk,” she said.

“It’s hard, though,” she said, referring to trying to get the word out about the potential dangers of raw milk. “Anyone drinking raw milk has a lot of views on healthy foods. They have to sort them out and separate the wrong information from the right information.”

And when people who know what happened to her children tell her it would never happen to them or that you can get E. coli from raw spinach too but no one stops buying it, she doesn’t take kindly to comments like that.

“I want to scream and say ‘you weren’t there. You have no idea what HUS can do.’ ”

Will they sue?Having two children in the hospital for three weeks being treated for HUS and pancreatitis is, without a doubt, expensive. Sarah estimates the hospital costs alone came to more than $100,000. With insurance, their portion of that was 10 percent.

“In addition to the hospital bills, you wouldn’t believe the bills we received,” she said. “We received individual bills from ER doctors, specialist physicians, hospital pediatric physicians, surgeons, anesthesiologists, labs, and the ambulance. Just when you think you have them compiled, you get another one. It was so overwhelming. “

The Combs family, from left, Titus, Brandon with Jubilee on his lap, Sarah with Lilia on her lap, and Zeke.

Fortunately, their church raised some of the money for medical expenses, which Sara said was a great help. For the rest, they used tax returns and set up payment plans.

“We’re still paying,” she said.

With all of the stress they were dealing with — figuring out insurance coverage, which involved multiple calls back and forth, for example — some of the bills went to collections.

“It was just all I could do to ignore it all for a while when we got home, just trying to get through the days without fear,” she said.

As for whether they’ll sue the farm and/or the store where they bought the milk, Sarah said this is something they’ve gone back and forth on.

“I feel bad for considering it because we chose to drink it. … I feel bad that the farmer and food club are small town, local businesses. But I always think, what if our suing stopped someone from getting HUS, what if someone died from this and our suing would have stopped the sales?”

Then, too she said, they still have medical bills and chances are their children will need funds for medical needs in the future because of the lasting impact of the HUS and pancreatitis.

]]>http://www.foodsafetynews.com/2016/11/parents-haunted-by-decisions-as-raw-milks-impact-lingers/feed/0Victim warns expectant moms about food safety complicationshttp://www.foodsafetynews.com/2016/09/victim-warns-expectant-moms-about-food-safety-complications/
http://www.foodsafetynews.com/2016/09/victim-warns-expectant-moms-about-food-safety-complications/#respondTue, 06 Sep 2016 05:00:45 +0000http://www.foodsafetynews.com/?p=131397Continue Reading]]>Almost 5 years old now, Kendall Paciorek is right on track. She can walk, run, talk and say her ABCs. And while that normal progression of abilities common to many children her age might not seem all that impressive, to her mother and father Michelle Wakley-Paciorek and Dave Paciorek, it’s “a miracle.”

Little Kendall was born three months premature on Sept. 21, 2011. Her early arrival was one result of a Listeria infection contracted from her mother who had eaten some contaminated cantaloupe the previous month. When she was born, the doctors warned her parents about all sorts of dire medical complications that she could develop: blindness, deafness, mental retardation, cerebral palsy, and others.

The dire prognosis was offered even before the doctors ran blood tests and discovered something even more troubling: Both mother and daughter had listeriosis, a foodborne disease. They had suspected that Michelle had an infection of some sort, but didn’t know what it was until getting the results of the blood tests.

“It was terrible,” said Michelle. “They didn’t even know why we were sick until the next day.”

Kendall is well on her way after a rough start in life. (Photos of Kendall courtesy of the Paciorek family)

The Listeria infections the mother and baby were suffering from were part of an outbreak traced to cantaloupes grown by Jensen Farms in Colorado in 2011. According to the Centers for Disease Control and Prevention, at least 147 people in 28 states were confirmed as part of the outbreak. At least 33 deaths and one miscarriage were officially attributed to the outbreak.

Kendall was one of three newborns diagnosed with Listeria infections during the outbreak.

A week before she was born, the U.S. Food and Drug Administration announced a voluntary recall of the entire crop of fresh, whole cantaloupe from Jensen Farms. But the news about the Listeria outbreak linked to cantaloupes wasn’t widespread when Kendall was born because people were just beginning to get sick. It can take up to 70 days for symptoms to develop after exposure.

Listeriosis is caused by Listeria, a type of bacteria that is commonly found in water, soil and feces. Raw vegetables and fruits can become contaminated with Listeria either through contact with soil or with animal manure that is used as fertilizer. Humans are infected when they consume foods or beverages that harbor the bacteria.

Listeria, which can survive freezing and grow in refrigerated temperatures above 40 degrees, is responsible for around 1,600 illnesses and 260 deaths in the U.S. yearly, according to the CDC. Pregnant women and their unborn babies are especially vulnerable, with pregnant women 20 times more likely to develop listeriosis than the general population.

Miscarriage or premature birth are two possible outcomes when a pregnant woman is infected with Listeria. In addition, a newborn babies who contract Listeria infections from their mothers might suffer a life-threatening infection in the days and weeks after birth.

Something just wasn’t rightFor Michelle and Dave, everything seemed to be going well, although for several weeks before Kendall’s birth, Michelle had been suffering flu-like symptoms, among them headaches, aching legs, sweats, chills and dry heaves. She attributed those symptoms to pregnancy, as did her doctor.

The last thing on her mind was that she was sick because she had snacked on some cantaloupe. She said she had eaten cantaloupe multiple times, wanting to eat healthy food including fresh fruits and vegetables while she was pregnant.

The day Kendall was born, Michelle and her then 4-year-old daughter Madison had gone to get pedicures, mainly as a pleasant diversion. While they were there, Michelle started having contractions. When she went to the hospital, she knew something was wrong.

“The baby was coming,” she said. “I couldn’t believe I was in labor.”

Later she found out that the contractions were as hard and painful as they were because the infection had advanced into her bloodstream. She said the baby reacted by pushing her way out in order to survive.

Born prematurely as a complication of her mother contracting an infection from fresh cantaloupe that was tainted with Listeria monocytogenes, Kendall required intensive medical treatment.

Kendall was immediately put into a neonatal incubator with tubes and machines attached to her on all sides. The tiny 3-pound, 11-ounce baby was fighting for her life.

She stayed in the incubator for weeks during which time her parents couldn’t hold her. Michelle said she could only put a finger into the incubator to touch her. For a parent, it was agonizing in many ways.

Several months later, Kendall was still on 24-hour watch and had to be fed through a tube in her stomach. She wasn’t thriving.

“Every time she ate, she vomited,” said Michelle.

Fortunately, the situation improved immensely when she was hooked up to an automatic drip feeder.

“She could hold things down,” said Michelle, the relief in her voice still obvious four and a half years later.

Just several days before her first Christmas, Kendall, who then weighed 7 pounds, was deemed to be strong enough to go home and sleep in her own crib.

When Kendall was 6 months old, Michelle enrolled her in a First Steps program, which helped her with her feeding and small motor coordination. Two therapists came to the house to do the therapy. She continued in the program for 18 months.

“It made all of the difference in the world,” Michelle said. “The early therapy was key to helping her thrive.”

Just recently, Kendall attended a reunion of parents and their children who had been in the Newborn Infants Care Unit at St. Vincent’s Hospital in Indianapolis.

“The nurses were amazed,” Michelle said. “She seems to be on track. We’re so lucky that she has overcome most of the odds.”

And while they’re pleased with their daughter’s mental development, Michelle said they won’t know how far she has come until she starts school and faces some harder challenges.

She’s small — very small for her age. She might have to go through a program of growth hormone shots based on her projected bone growth.

“Right now, we are feeling very hopeful,” said Michelle.

Yet she has this recurring question: “You look back,” she said “and think: All of this because of food?”

According to the FDA report: “. . . several areas on both the washing and drying equipment appeared to be uncleanable and dirt and product buildup was visible on some areas of the equipment, even after it had been disassembled, cleaned and sanitized.”

But there was something else that was even more troubling. The farm had removed its antimicrobial wash, which meant that melons could cross-contaminate the equipment and one another. In that way, an entire production line could spread the bacteria. In other words, just one contaminated melon could contaminate each and every melon that went after it.

The melons were distributed to hundreds of supermarkets and retailers across the nation.

For Michelle, there are no excuses for this disregard of sanitation and human health.

“People doing things like this aren’t held accountable for their actions,” she said. “To save money, they’re are cutting corners. They don’t want to pay what it takes to keep the food they’re growing and selling to the public safe.”

She said she’s hopeful that the stricter regulations under the Food Safety Modernization Act, which was signed into law in 2011, will help. But she also knows that the government can’t monitor everything. She worries that some pregnant moms, aren’t paying enough attention to the food they eat, some of which, if contaminated, can kill their babies.

Her unequivocal advice to other parents comes down to this: “Be aware. Understand what kind of foods you shouldn’t eat when you’re pregnant. And know that what happened to our family could happen to you.“

Food safety ABCs for pregnant momsAccording to FDA’s “Food Safety for Moms-to-Be” website, pregnant women can become sick from foodborne illnesses, often referred to as food poisoning, when they eat or drink food or beverages that contain harmful microorganisms such as bacteria, parasites or viruses.

Expectant mothers are more susceptible than the general public to foodborne illnesses because of the impact pregnancy has on their immune systems. Their unborn children are also at risk from foodborne pathogens. The FDA updated its advice for pregnant women earlier this year. Click on the image to see the information.

Pregnant women are especially vulnerable to foodborne illnesses because the immune system changes during pregnancy as a way to help the mother and unborn baby “get along with each other.” The unborn baby is vulnerable because its immune system has not developed enough to fight off harmful foodborne microorganisms.

Symptoms can vary — stomach ache, vomiting, and/or diahrrea, fever, headache and body aches. Because the symptoms are often similar to the flu, many women assume they’ve caught a seasonal virus. In other cases, the mother doesn’t experience any symptoms at all, even though she’s been infected. Even so, she can pass the infection to her unborn child through the placenta.

Symptoms usually appear in one to three days, although they can show up in as short a time as 20 minutes or as long a time as up to 10 weeks after eating or drinking contaminated food or water.

Pregnant mothers experiencing these symptoms of food poisoning should contact their doctors.

In general, the foodborne pathogens of most concern to pregnant women are Listeria and Salmonella, primarily because maternal infection can raise the risk of adverse pregnancy outcomes. However, other pathogens such as E. coli and Campylobacter are also of concern.

What foods to avoidAccording to the Women’s Health Division of the U.S. Department of Veterans Affairs, pregnant women should avoid these foods:

Salads made in retail locations, including as ham salad, chicken salad, tuna salad or seafood salad.

Mercury, a harmful metal found in high levels in some fish, especially larger and older fish, is particularly of concern. Because unborn and newborn babies are more sensitive to mercury than are adults, pregnant and breastfeeding mothers should avoid eating fish with high levels of it. Some of the fish with high concentrations of mercury are king mackerel, shark, swordfish and tile fish. Also to be avoided are raw fish found in foods such as sushi and sashimi. In addition, albacore or white tuna and tuna steaks have more more mercury than light tuna.

The U.S. Department of Agriculture offers specific advice for mothers and pregnant women about which fish and seafood is safe on its website.

About those catsPregnant women, and even women contemplating pregnancy, need to take special care to protect themselves and their unborn babies from an infectious parasite known as Toxoplasma gondii (T. gondii).

Because cats can spread this parasite through their feces, pregnant women are advised to have someone else change litter boxes, if possible. If not, then they should wear disposable gloves and wash their hands thoroughly with soap and water afterwards.

Cats carry the parasite but do not show any symptoms of an infection.

The parasite is also found in soil and outdoor places such as sandboxes. For this reason, it infects just about all cats that spend any time outdoors. They can become infected by eating small animals such as mice, or raw meat that’s infected. When this happens, the parasite is passed on through the feces.

If a woman becomes pregnant while the parasite is still in her blood, it can pass through the placenta to her unborn child. In babies, toxoplasmosis, the disease caused by T. gondii, can cause hearing loss, intellectual disability, and blindness. Some children can develop brain or eye problems years after birth.

Also, according to the CDC, it is considered to be a leading cause of death attributed to foodborne illness in the United States. More than 60 million men, women and children in the U.S. carry the Toxoplasma parasite, but very few have symptoms because their immune systems usually keeps the parasite from causing illness.

However, CDC warns that women newly infected with Toxoplasma during pregnancy and anyone with a compromised immune system should be aware that toxoplasmosis can have severe consequences.

Just to be safe, pregnant women who have cats that are allowed to go outdoors are advised to be tested. Medications are available that will clear up the infection.

When it comes to food, the parasite can also be found in raw and undercooked meat; unwashed fruits and vegetables; and contaminated water. About half of the toxoplasmosis infections in the United States each year are acquired from food.

]]>http://www.foodsafetynews.com/2016/09/victim-warns-expectant-moms-about-food-safety-complications/feed/0Mother of Jack in The Box outbreak victim dieshttp://www.foodsafetynews.com/2016/01/mother-of-jack-inthe-box-outbreak-victim-dies/
http://www.foodsafetynews.com/2016/01/mother-of-jack-inthe-box-outbreak-victim-dies/#respondWed, 13 Jan 2016 06:05:59 +0000http://www.foodsafetynews.com/?p=122466Continue Reading]]>Suzanne Kiner, food safety advocate and mother of one of the child victims of the infamous 1993 Jack in The Box E. coli outbreak, died Jan. 5, 2016, at age 67.

Kiner’s daughter Brianne was 9 years old in 1993 when she contracted what developed into a life-threatening infection from E. coli in a fast food hamburger. The girl was not expected to live, but she turns 33 this month.

Four of the 623 families whose loved ones got sick from the undercooked Jack in The Box burgers were not that lucky. The E. coli O157:H7 outbreak claimed the lives of four children, according to public health records.

Brianne Kiner spent six months hospitalized, part of it in a coma, following the E. coli diagnosis. During that time six lawyers met with her family at her bedside to discuss legal options. The Kiners hired Bill Marler, a virtually unknown trial lawyer in Seattle.

The $15.6 million settlement Marler won for Brianne Kiner and her family from Jack in The Box and its parent company Foodmaker Inc. was the largest of its kind when it was awarded.

The Jack in The Box outbreak and the investigation into it thrust foodborne illness onto the national stage with Suzanne Kiner, her daughter and other victims speaking out about the need for food safety regulations and protocols. A sea change in food safety awareness followed in the United States. Government increased minimum cooking temperatures for certain foods and defined E. coli O157:H7 and several other foodborne pathogens as unacceptable “adulterants” in food.

In a blog post Jan. 12, Marler described Suzanne Kiner as an “E. coli hero” and recalled her devotion to her daughter.

“During her daughter’s E. coli illness in 1993 she never left the hospital for over six months and seldom left her daughter’s bedside. She willed her daughter to survive and to recover as much as the E. coli bacteria would allow,” Marler wrote.

“I will always be humbled and honored that she hired me to represent the family against Jack in the Box.”

Most recently Suzanne Kiner lived in Mulkiteo, Wash. The Seattle Post-Intelligencer newspaper published her death notice Jan. 11. Neither the Seattle newspaper nor the Mulkiteo Beacon had any additional details as of Jan. 12.

Editor’s note: To mark the 20th anniversary of the Jack in The Box outbreak, Food Safety News published a Q&A with Brianne Kiner. Read it here.

Food safety attorney Bill Marler is also the publisher of Food Safety News.

]]>http://www.foodsafetynews.com/2016/01/mother-of-jack-inthe-box-outbreak-victim-dies/feed/0NE Couple Wins $11.37-Million Judgment in Salmonella Casehttp://www.foodsafetynews.com/2015/10/nebraska-couple-wins-11-37-million-judgment-in-salmonella-case/
http://www.foodsafetynews.com/2015/10/nebraska-couple-wins-11-37-million-judgment-in-salmonella-case/#respondFri, 30 Oct 2015 05:01:29 +0000http://www.foodsafetynews.com/?p=119458Continue Reading]]>Back in October 2010, Chris and Heather Gage were 120 miles away from their home in Bridgeport, NE, and decided to dine at the Old Country Buffet in Cheyenne, WY. Chris Gage was medically compromised going into the restaurant, but when he left, he was infected with Salmonella bacteria, which left him forever damaged.

Gage’s reaction to the pathogen was extreme, and he and his wife went on to sue the Old Country Buffet (now known as Ovation Brands) in 2014. This past week, the couple won an approximately $11.37-million judgment against the defendants in Wyoming federal court.

This case was unusual because all the time that the Gages and their attorneys sought justice in the courtroom, the defense table remained vacant.

Ovation Brands, one the largest restaurant chains in the country, did not show up to defend itself. It won’t say why. Court documents show that it was properly served notice of the lawsuit.

Not showing up in court after being served notice that you are being sued can put you in default. After that, the plaintiffs may put on evidence for assessing damages without any of it being contested. Then the judge is free to make a default judgement.

“The lesson from this case is that if you are sued, get a lawyer,” says Seattle food safety attorney Bill Marler (who is also publisher of Food Safety News).

After U.S. District Court Judge Scott Skavdahl entered a default order against Ovation Brands in August, the only thing left to be decided was the amount of the judgment. In addition to the $641,936.50 he had earlier entered, the judge added $10,729,536, for a final judgment amount of about $11.37 million.

Now the Gages just have to collect from defendants they’ve not seen from a restaurant that has closed and from a restaurant chain that has changed its name and gone bankrupt and been sold to another restaurant group during the past five years while Gage’s illness left him fighting for his life.

Being from out of town, the Gages probably did not know that others in the Cheyenne area were sickened from eating at the Old Country Buffet during September 2010. Those illnesses brought the Laramie County Health Department out to the buffet-style restaurant for an inspection on Sept. 30, 2010, where 18 violations were discovered. The Gages decided to eat there the following day. But while others might have been sick for a week from the restaurant’s Salmonella contamination, Chris Gage was what doctors call “a particularly vulnerable individual” because of a pre-existing condition.

The military veteran was treated in 1997 for gastroesophageal reflux disease, otherwise referred to as GERD. The surgery was successful, and Gage then had no more symptoms before he was infected with Salmonella in 2010. What happened after that nearly killed him.

The Salmonella infection brought on gastrointestinal symptoms, including abdominal pain, vomiting and diarrhea, and it became even worse. Gage could not go to the bathroom or walk on his own, hold down water, or stop his vomiting and dry-heaving.

Gage was taken by ambulance to the Regional West Medical Center in Scottsbluff, NE, where doctors found him in total renal failure from Salmonella infection and resulting septic shock.

Doctors providing court testimony said that Gage’s condition before the Salmonella infection was “stable, controlled and asymptomatic” and that “to a reasonable degree of medical certainly,” the food poisoning was the cause of his future medical problems. Before September 2010, Gage was functioning completely independently. Salmonella left Gage with damage to the pons region of the brain, which is the area responsible for controlling eye movements, balance, arm and leg movements, fine motor skills, respiration, nausea and vomiting, expression of emotions and speech and language.

“Since the Salmonella poisoning, Mr. Gage has suffered from persistent nausea, vomiting, balance and coordination issues, cognitive deficits, emotional control issues, and speech and language problems,” Dr. Jason D. Walsh, a Scottsbluff surgeon, said in a declaration summarizing Gage’s medical history and condition.

At about the same time that the first default judgement was entered representing Gage’s out-of-pocket medical expenses, Food Management Partners acquired Ovation Brands. The 350-unit restaurant chain was said to have 18,000 employees and $900 million in annual revenues.

Its six brands, including Old Country, are run out of Greenville, SC, with a corporate support center in Eagan, MN. Terms of the Food Management Partners acquisition of Ovation were not disclosed.

]]>http://www.foodsafetynews.com/2015/10/nebraska-couple-wins-11-37-million-judgment-in-salmonella-case/feed/0Update: Two Maine Boys Were Infected by Same Strain of E. Colihttp://www.foodsafetynews.com/2015/10/maine-boy-succumbs-to-e-coli-complication-another-battles-on/
http://www.foodsafetynews.com/2015/10/maine-boy-succumbs-to-e-coli-complication-another-battles-on/#respondFri, 09 Oct 2015 19:03:49 +0000http://www.foodsafetynews.com/?p=118383Continue Reading]]>Oct. 9 update: A state epidemiologist with the Maine Center for Disease Control and Prevention announced Friday that the two boys who became ill after visiting a petting zoo last month were both infected by E. coli O111.

“The strain and molecular typing from each patient was identical, making it highly likely that the cases acquired the illness from same source,” said Dr. Siiri Bennett, adding, “We cannot say with certainty what that common exposure might have been.”

She said that state health officials have collected and are testing environmental samples from the main barn, outside animal pens and the livestock area for the petting zoo at the Oxford County fairgrounds in Oxford, ME.

Previous illness outbreaks involving E. coli O111 have been linked with exposure to a dairy at a Colorado correctional facility and with consumption of raw beef and green whole head cabbage.

Previous coverage of this story follows:

Two Maine boys, 20-month-old Colton Guay and 17-month-old Myles Herschaft, visited the petting farm at the Oxford County Fair in September. Now Colton is dead, and Myles is battling a life-threatening kidney complication of E. coli infection, which is the same infection Colton had before he died.

Victor Herschaft wrote in a Facebook post Tuesday, Oct. 6, that his son “is keeping up the battle” against hemolytic uremic syndrome (HUS) and took comfort in the fact that Myles had smiled for the first time since the nightmare began.

Both the Maine Center for Disease Control and the Maine Department of Agriculture, Conservation and Forestry are investigating to determine where the two boys were exposed to the dangerous pathogen. State officials are also testing to determine the type of E. coli bacteria involved.

However, the parents of the boy who died are not waiting. Jon and Beth Guay are warning other Maine parents of the risks to children who come into contact with farm animals at petting zoos found at county fairs.

Myles Herschaft

The two families met at the Maine Medical Center in Portland. Jon Guay, a deputy sheriff for Androscoggin County, and he found that both boys had visited the same petting farm exhibit at about the same time. Maine CDC conducted laboratory tests at the fair exhibit area and found the presence of Shiga toxins associated with E. coli.

The two Maine boys are only the latest to become infected with E. coli then develop HUS. According to the National Institute of Diabetes and Digestive and Kidney Diseases, it is the most common way for children to come down with HUS.

The digestive system is made up of the gastrointestinal, or GI, tract — a series of hollow organs joined in a long, twisting tube from the mouth to the anus — and other organs that help the body break down and absorb food.

Normally, harmless strains, or types, of E. coli are found in the intestines and are an important part of digestion. However, if a child becomes infected with the O157:H7 strain of E. coli, the bacteria will lodge in the digestive tract and produce toxins that can enter the bloodstream. The toxins travel through the bloodstream and can destroy red blood cells.

Colton Guay

Petting zoos and farms have been a common source of E. coli transmission.

Maine has 26 privately operated agricultural fairs that fall under some supervision by the state agriculture department. The department reportedly inspects all animals participating in the fairs.

The Oxford County Fair told local media outlets that it has signs to encourage visitors to wash their hands after visiting the exhibit and stations for hand-washing and/or sanitizing.

Guay said that if he’d known that his son could pick up the bacteria just by touching the animals, he would not have taken his family to the fair.

]]>http://www.foodsafetynews.com/2015/10/maine-boy-succumbs-to-e-coli-complication-another-battles-on/feed/0Schacht Interview: Using Restaurant Inspection Data to Improve Public Healthhttp://www.foodsafetynews.com/2015/05/schacht-interview-using-restaurant-inspection-data-to-improve-public-health/
http://www.foodsafetynews.com/2015/05/schacht-interview-using-restaurant-inspection-data-to-improve-public-health/#commentsThu, 14 May 2015 05:01:19 +0000http://www.foodsafetynews.com/?p=111461Continue Reading]]>Open government consultant and food safety advocate Sarah Schacht sat down with Food Safety News at the 2015 Food Safety Summit in Baltimore, MD, last month to talk about how data from restaurant inspections can help improve public health. Schacht is a two-time E. coli survivor who has been spearheading efforts in Seattle’s King County to improve access to restaurant inspection information.

She discusses her trials with E. coli, her work to bring a new type of restaurant placarding system to King County, and the benefits of providing more easily accessible restaurant data to the public through services such as Yelp.

For more information on Schacht and King County’s move toward more accessible health inspection information, Food Safety News has been covering the topic:

Detwiler’s son, Riley, was one of four children who died in the 1993 Jack in the Box E. coli outbreak. Since that outbreak, Detwiler has pushed for a safer food system through various roles.

Watch the interview below:

]]>http://www.foodsafetynews.com/2015/05/interview-with-darin-detwiler-on-food-safety-from-a-consumer-perspective/feed/2Mom Honors Her Daughter’s Memory With ‘Playroom Project’http://www.foodsafetynews.com/2015/04/mother-wants-to-honor-daughters-memory-with-hospital-mobile-playrooms/
http://www.foodsafetynews.com/2015/04/mother-wants-to-honor-daughters-memory-with-hospital-mobile-playrooms/#respondTue, 28 Apr 2015 05:01:40 +0000http://www.foodsafetynews.com/?p=110648Continue Reading]]>It’s been nearly a year since her daughter, Olivia, 3, passed away from complications relating to an E. coli infection, and Haley Cruz wants something positive to come from the tragedy. Along with a bakery in Van Alstyne, TX, named after her daughter, Sweet Olivia’s Bake Shoppe, Cruz has started a special project to help entertain sick children who are hospitalized for foodborne and other illnesses.

The fundraising effort is aimed at buying new toys and games for two playrooms at the Texoma Medical Center in Denison, TX, where Cruz once worked and where Olivia was treated before eventually being transferred to a Dallas hospital, where she died May 27, 2014.

Alex, Haley, and Olivia Cruz

“[Olivia] was so bored; even if they’re little and they’re sick, they still want to play and do something. That would be a perfect way to keep Olivia’s memory alive and give those kids in the hospital sick like she was something to do,” Cruz told Food Safety News.

Hospital pediatric floors and other areas where children are treated for illnesses often get donated stuffed animals and toys, but it’s nice to have new things and keep them rotating so that sick kids have a variety of something new, she added.

“The plan is to have mobile stations full of toys that they can take into their rooms and play with the whole time they’re sick,” Cruz explained. “When they’re discharged, [the toys] can all be sanitized and go back.”

Cruz said she cleared the project with Texoma Medical Center’s head of pediatrics, who told her that the staff couldn’t think of anything better to help remember Olivia, who was born at the Denison hospital.

“A lot of the nurses on the floor knew her very well. It wasn’t just that I lost her, they lost her as well,” Cruz said.

Olivia first became ill in mid-May of last year with unexplained bloody diarrhea, her mother said. She took Olivia to her pediatrician, who diagnosed the little girl with the flu and prescribed antibiotics. It was the same story at the hospital emergency room, Cruz said.

“They just discharged her as having the flu. I took her back to her pediatrician the next morning, and he just said it’s a stomach bug, and if she’s not any better this afternoon, call me,” Cruz recalled.

After not being able to reach the pediatrician later the same day, she called another one who told her something was wrong and to get Olivia to the hospital.

“I met him there, and he started treating her for some other stomach thing, not E. coli,” Cruz said. Eventually testing was done for E. coli and the positive result came back three days later.

“At that point, her kidney levels and everything were off the charts,” Cruz said. Olivia was then transferred to Medical City Hospital in Dallas.

Alex and Olivia Cruz

Olivia had developed a life-threatening complication known as hemolytic uremic syndrome, or HUS, which occurs in about 5-10 percent of those infected with E. coli 157:H7. According to the U.S. Centers for Disease Control and Prevention (CDC), most people with HUS recover within a few weeks, but some of them suffer permanent damage or die.

Cruz and about 50 other mothers of children who have had HUS are linked up via a special Facebook page, and Cruz said that it’s been a helpful way to share their common experiences.

“Parents will post all the time about their child six-month post-HUS who is having these symptoms, and did you child have that?” she said.

How Olivia got an E. coli infection was never completely clear, Cruz said, although her illness occurred right around the time of the May 19, 2014, recall of 1.8 million pounds of ground beef linked to Wolverine Packing Company of Detroit.

While out grocery shopping, Cruz said her daughter used to poke her finger into a package of ground beef in the cart, and it’s possible that she could have gotten some raw product on her finger and then put it into her mouth.

“That’s about the only thing I can think of,” Cruz said, adding, “If your child’s going to die, you want to know how or why, what caused it. If you don’t know, you can’t protect your other children.”

She called her only daughter “a fiery, spunky little girl” who liked to hang out with the boys, including her older brother, Alex.

“Sweet Olivia’s Playroom Project,” hosted by gofundme.com, has already raised about $2,000 of the $25,000 goal since Cruz launched the effort April 15. As part of the fundraising effort, she also launched a Booster T-shirt project, which has brought in more than $500 so far.

Meanwhile, Cruz said there are plans in the works for a couple of fundraising events later this summer and some sponsorships opportunities for those donating to have their name on a special plaque in the hospital playroom.

]]>http://www.foodsafetynews.com/2015/04/mother-wants-to-honor-daughters-memory-with-hospital-mobile-playrooms/feed/0Listeria Victims Address FDA, Food Industry Officials in D.C.http://www.foodsafetynews.com/2015/04/listeria-victims-address-fda-food-industry-officials-at-fsma-meeting/
http://www.foodsafetynews.com/2015/04/listeria-victims-address-fda-food-industry-officials-at-fsma-meeting/#commentsMon, 27 Apr 2015 05:01:20 +0000http://www.foodsafetynews.com/?p=110581Continue Reading]]>A year ago, Brad Frey never would have imagined he’d be standing in front of officials from the U.S. Food and Drug Administration and urging them to do more to prevent outbreaks of Listeria monocytogenes. Despite living in the middle of “crop country” outside Santa Cruz, CA, he had never heard of Listeria monocytogenes, a foodborne bacteria less well-known than Salmonella or E. coli, but one that can more often be fatal.

But Frey was painfully aware of Listeria by December 2014, when his mother, Shirlee Jean Frey, passed away from a Listeria infection after eating a contaminated caramel apple purchased at Safeway.

This past week, he and other foodborne illness victims from around the U.S. traveled to Washington, D.C., to meet with congressional aides and have the opportunity to directly address FDA and food industry officials at the agency’s kickoff meeting for implementing the Food Safety Modernization Act (FSMA).

Brad Frey holds his phone while a video plays of his parents dancing in their driveway two years ago. His mother, Shirlee Jean Frey, died from a Listeria infection in December after eating a contaminated caramel apple. Frey and other victims shared their stories with federal lawmakers last week in Washington, D.C.

“In December, my mother passed away from Listeria,” Frey said, speaking to FDA officials in the audience and a panel of food industry representatives taking questions. “Since the caramel apple outbreak, we’ve seen three more outbreaks in the news. It’s pretty heartbreaking to know that testing could have saved lives, but not enough testing is being done.”

Frey went on to ask the industry panel and FDA what specifically they were going to do to reduce the risk of Listeria illnesses going forward.

None of the industry panelists opted to answer, but Frey did get a quick response from Roberta Wagner, director of regulatory affairs at FDA’s Center for Food Safety and Applied Nutrition.

That’s what FSMA is all about, Wagner said — making sure that food companies and FDA work to eliminate preventable foodborne illnesses because so many of them are preventable.

Frey was soon followed at the microphone by John McKissick, a retired teacher and consultant from Pennsylvania who fell ill with Listeria three years ago after eating contaminated cheese imported from Italy and France.

McKissick spent two months hospitalized, six weeks of that time unconscious. The infection caused significant nerve damage and, as a result, he had little choice but to retire from work.

“In many cases, Listeria infection is a life sentence,” he told FDA officials. “It cannot be taken lightly.”

McKissick asked how FDA was going to reduce Listeria illnesses and improve the safety of imports through its foreign supplier verification program, a core component of the new regulations included in FSMA.

Agency officials are working to ensure that not only will they be setting strong standards for the companies that audit foreign food suppliers, but they’re setting up “rigorous protections” to make sure there are not financial ties between the suppliers and the auditors, said Charlotte Christin, special assistant to the director of the Office of Compliance within FDA’s Center for Food Safety and Applied Nutrition.

The foreign inspection program will require importers to take a “proactive responsibility” for food safety in a way they were not held accountable before, added Deb DeVlieger, national food expert for FDA’s Office of Food and Feed.

The panelists moved on to other questions, but Frey and McKissick were soon surrounded by supporters sharing stories and thanking them for coming to speak at the meeting.

“One lady from the FDA came up to me after I spoke and said, ‘Every day when I go to work, I think of people like you,'” Frey told Food Safety News after the panel discussion. “That felt good. You want them to be thinking about the victims.”

Frey’s mother was 81 when she contracted Listeria, but she was still very active prior to her illness. She and her husband, Jim, still liked to dance, and she had many more years of life in her, her son said.

“I’m afraid he’ll be an additional casualty in a way,” Frey said. “There’s collateral damage in these outbreaks. It’s not just the victim who suffers.”

Both Frey and McKissick said they came to meet face-to-face with FDA and food industry representatives to be a reminder of why food safety is so important. The victims can’t get lost in the shuffle of discussions over regulations and costs, McKissick said.

“Listeria is a miserable illness, and I want to make sure no one else gets it,” he told Food Safety News after addressing the panel.

A day earlier, McKissick and Frey met with aides to their respective U.S. senators to encourage Congress to come up with the additional $109.5 million FDA says it needs to fully achieve protections sought by FSMA.

Frey said that his mother’s passing has led to an educational experience into the workings of laws and regulations related to food safety.

From a distance, it’s frustrating to feel that food companies have so little oversight that her mother could get Listeria from eating something as seemingly harmless as a caramel apple, he said. But after meeting with congressional staff and speaking with FDA officials, he has more appreciation for the daunting task of making the nation’s food system safer.

Following his mother’s death, Frey’s family retained food safety law firm Marler Clark (which underwrites Food Safety News) to represent them in a wrongful death complaint.

Frey, McKissick, and other foodborne illness victims were invited to Washington, D.C., by the Pew Charitable Trusts, whose Food Safety Project aims to be a voice for consumers in dialogues about food safety regulations.

McKissick said he hopes both FDA and industry officials will remember the victims as they adjust to the new FSMA regulations rolling out over the next year.

“Food is so important, and yet it leaves us vulnerable to all sorts of illnesses,” he said. “Our health shouldn’t just be the luck of the draw.”